Romney or not, GOP's coming for 'Obamacare'

With the general election now in sight, Republican strategists and party officials have begun crafting a strategy that puts health care front-and-center in the campaign against President Barack Obama, even if Mitt Romney is at the top of their ticket.

GOP strategists are almost unanimous in their desire to keep campaigning on the issue that helped Republicans take control of the House in 2010. But the anti-“Obamacare,” anti-big-government war cry of the midterm campaign requires some freshening in 2012.

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A pair of major developments hang over the party two years later: the Supreme Court is expected to rule in June on the president’s health care law, and it could strike it down entirely or leave parts or all of it intact; and Republicans are now likely to be running alongside Romney, who enacted a similar law while Massachusetts governor.

Depending on how the Supreme Court rules, Republicans could either find themselves stripped of a key talking point — that the law is unconstitutional — or in the case that the law is overturned, competing to propose alternate fixes to what they also have called a broken existing system.

The messaging challenge if the law gets killed is problematic for Democrats. But the more immediate trick is how Republicans run against "Obamacare" with Romney at the top of their ticket.

The former governor has pledged to repeal the law but signed a measure in Massachusetts with related core components, including health insurance exchanges and a mandate that citizens buy coverage. While the state and federal laws are not identical, there’s enough overlap to cause political headaches for Republicans railing against mandates as egregious violations of individual liberty.

One solution, top Republicans say, is to make the party’s message smaller, or at least more surgical: targeting specific unpopular provisions of Obama’s law without necessarily going nuclear on health care in the same way they did in 2010.

“I don’t think you can do the 2010 message, at least in a full-throated way, in 2012 with Gov. Romney as the nominee,” said Virginia Attorney General Ken Cuccinelli, who became a national conservative hero thanks in part to his litigation against health care reform.

Cuccinelli credited Romney with his readiness to “engage on this issue” of health care but suggested that the contrast between him and Obama would be subtler than the one Republicans drew last cycle.

“He’s someone who’s demonstrated a willingness and ability to follow through on a plan,” the Virginian said of Romney. “I don’t think anybody doubts that Gov. Romney favors repeal.”

Republican operatives eyeing down-ballot races laid out a list of areas with which their candidates could attack Democrats without inflicting collateral damage on Romney, pointing to the federal law’s elimination of the Medicare Advantage program, its creation of an Independent Payment Advisory Board to trim Medicare costs and the possible price tag of implementing the federal law.

Outside groups aligned with the GOP in 2012 have poll-tested a number of health care messages and remain convinced that the law is an effective political cudgel for the GOP, even if it’s wielded more selectively.

“I would say that health care continues to be an extremely dominant issue that can be used by Republicans in the fall, most notably when you look not only at the broader debate over the bill but particularly with regard to key elements within the bill,” said Brian Walsh, president of the American Action Network. “Whether that be the $500 billion cut to Medicare, whether that be the IPAB — those unelected bureaucrats — many of the taxes, as well as the news stories that have come out recently with respect to assumptions about the health care bill that are now being revised by the Congressional Budget Office.”

Add it up and there are plenty of salient differences, Walsh argued, “between the president’s health care bill and what was done in Massachusetts.”

Paul Lindsay, communications director for the National Republican Congressional Committee, sketched out a message that has “less to do with the individual mandate than it does about the bureaucracy and regulations that Obamacare created.”

“Voters are viewing this through the 1099 requirements, they’re viewing it through Medicare cuts, they’re viewing it through the employer dropping them or their doctor not being able to treat them anymore,” he said.